Sleep is absolutely essential for good health. And far too many of us — our children included — don’t get enough sleep.
The Centers for Disease Control wanted to learn directly from parents how their kids, ages 4 months to 14 years, are sleeping. According to the National Survey of Children’s Health (2020-2021), 31% of kids in Michigan get less sleep than is recommended for their age. Other states fared worse!
Children with autism often struggle with falling asleep and staying asleep — just like many kids without autism. However, the solutions that work for one group may not work for the other.
As a first step in supporting sleep, you can use tried-and-true solutions, adapted for your child’s unique needs and interests, to help them wind down and get better sleep, says Melissa Maye, Ph.D., a psychologist at the Henry Ford Health’s Center for Autism and Developmental Disabilities (CADD).
Here, we share what you need to know to help your child get the best sleep possible.
Don’t discount mainstream evidence-based strategies until you have tried them
Mainstream parenting books and websites present evidence-based strategies to achieve sustained sleep, and many of them will work for a child with autism.
“Developing, and sticking to, a regular nighttime routine is one strategy that will help many children get to sleep and stay asleep — the most important key is consistency and patience. Bath, book, bed is a common routine many parents use and is easy to remember,” says Maye.
What do sleep experts recommend?
Like other sleep experts, Jodi Mindell, author of Sleeping Through the Night: How Infants, Toddlers and Their Parents Can Get a Good Night’s Sleep, recommends creating a bedtime routine with your child.
But a communication barrier, for instance, can make a routine difficult to follow for a child with autism.
“When you’re saying first we’ll brush our teeth, then snuggle, then story, then bed, but your child’s ability to understand language is limited, certainly that’s not going to be a really effective way to set up and establish that routine,” says Maye.
She further elaborates that these routines can be adapted by using communication strategies such as pictures of a child or your child brushing their teeth and putting them in order on a posterboard or taping them near the location of the activity taking place, for example, a picture of child brushing next to the bathroom mirror.
Can you identify what calms your child?
The trick is to identify soothing activities for your child based on their individual interests.
“Maybe if there’s a special sensory toy they like to use, or a soft blanket or soft toy that parents have identified as something that helps them calm down, you might consider adding that into the routine,” she says. This is another example of how parents of autistic children might adapt mainstream evidence-based sleep strategies to the unique needs and interests of their child.
Watch out, though, for too much of a good thing. “Sometimes parents will notice that their child’s sensory toy is calming, whereas for other children the sensory toy can be considered very exciting and stimulating. In that case, it wouldn’t be good to incorporate into the sleep routine,” Maye explains. So, ahead of deciding to incorporate a toy or object into your child’s sleep routine it would be good to observe your child using that special toy or object for a couple days to understand the behavior more.
How to create a bedtime routine that works
Start with some common parenting resources to get some ideas for a routine that you think could work for your child and your family. “I really like bath-bottle-book-bed if they’re at that developmental stage because it’s easy to remember and you don’t have to write anything down,” Maye suggests, adding that you can adapt this to substitute a cup of milk for the bottle if that works.
As your child gets older, be prepared for this routine to change. As the routine becomes more complex, write down the steps if you find that it helps to stay consistent. “And then, if it works for your child, really get them into the habit of knowing what’s going to happen next,” she says.
If you’re using a social story or pictures for your routine, you can display them in your home, or give your child a card that matches the step of the routine so they can Velcro it to a board.
These steps are important because they give your child agency. “Anytime I can give a child agency, no matter what their developmental level, I will do that because I think that empowering a child and giving them a choice in the matter increases the likelihood that they’ll participate and learn the routine and that it might benefit them,” Maye says.
Offering choice in the bedtime routine is another way to give your child agency. Let your child choose between the book you will read each night, or between two pajama options, for example.
What might happen to your child’s sleep as they grow?
Just when you’re feeling confident about your child’s bedtime routine and you’re finally getting some sleep predictability, things will change. Count on this.
“They’re going to grow, they’re going to have a sleep regression,” Maye says. “At times, you will experience a setback or your child will developmentally move into the next phase.” What worked at 5 years old may no longer work at 8 years old – and that can just be considered typical growth and development.
You will reach a time when your family routine and habits will change, no matter how much you work to create consistency. For example, when children enter school they may have more after school activities that interfere with an existing bedtime routine. Recognizing this now may allow you to approach your overall choices with more flexibility. “Make sure you are engaging in activities that boost your morale and make you feel happy,” Maye says. “I encourage parents to take those opportunities, especially knowing that sleep changes all the time. Go to an overnight where maybe it’s not the same sleep environment if you want to get away and see the beach.”
Share bedtime responsibilities whenever possible
Parents know how hard it is to get a reluctant child to settle down to sleep. It’s even more exhausting when one parent is doing it alone. If you have a partner at home, share bedtime responsibilities.
“If both parents share equally, the child gets used to it being a shared thing, ‘Mom or dad can put me to bed’ or ‘Mom or mom can put me to bed,’” Maye says. Bedtime can be a shared responsibility, whether you are parenting across households or in the same house.
Each parent can have a slightly different routine, and that’s a good thing — as long as there is consistency and alignment with evidence-based practices.
If you notice your young child gravitating to one parent’s style, gently try to push through early behavioral challenges with consistency and responsiveness to what calms your individual child and honors their needs. Lean into early flexibility your child with autism may have to set the standard for shared parental responsibility.
“That’s a very generalizable thing we want. I have seen parents who are the only person who can feed and put their child to bed through age 3, and it’s a very stressful thing. It can be hard to break, too, if you let it go on for three years,” Maye explains.
What to do if you are the only parent
As a parent, you need a full night of sleep to function properly — preferably every night. That’s all the harder if you are parenting solo. Get help from a responsible adult, if you can.
“I know it’s so hard for many adults to ask if they have an adult friend or adult family member, could you come over so I can take a nap or could you come over one night this week so I can sleep through the night?” suggests Maye.
Check to see if you qualify for respite services, which can provide care for your child and allow you to get some much-needed sleep.
Content sponsored by Henry Ford Health Center for Autism and Developmental Disabilities. Learn more at henryford.com/services/autism.
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